Ocvirk, J., & Cencelj, S. (2009). Management of cutaneous side-effects of cetuximab therapy in patients with metastatic colorectal cancer. Journal of the European Academy of Dermatology and Venereology, 24, 453–459.
To evaluate the effectiveness of various interventions to manage the skin effects of cetuximab.
All 31 patients developed the typical acneform rash that occurs from six to 20 days after the first dose of cetuximab. Emollients were recommended for grade 1 acneform eruptions. For patients who developed grade 2 reactions, the same topical treatment as for grade 1 was used, with the addition of topical antibiotic treatment: 1% solution of clindamycin BID for two to three weeks until pustules ceased. The H1 antihistamine loratadine was recommended to relieve itching.
All patients were advised to wash with bath oil or shower with tepid water, avoid sun exposure, and use sunscreen products with high sun protection factor. For grade 1 rash, patients were advised to use topical preparations for moisturizing that contain dexpanthenol (e.g., Bepanthen® cream or lotion), applied BID. For grade 2 rash, patients used the same topical preparation, plus a topical antibiotic treatment. Finally, for grade 3 rash, treatment with cetuximab was discontinued until the reaction resolved and a combination of emollients, topical antibiotics, and systemic antibiotics was given.
Institute of Oncology in Ljubljana, Slovenia
This was a descriptive study on the effectiveness of various interventions for dermatological toxicities related to cetuximab.
Skin toxicity was evaluated using the National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE), version 3.
Grade 3 skin rash was generally manageable with emollients, topical antibiotics, and systemic antibiotics. The effectiveness of emollients on grade 1 and 2 rashes was not reported.